AIMS Medical Science, 2016, 3(3): 272-277. doi: 10.3934/medsci.2016.3.272

Research article

Export file:


  • RIS(for EndNote,Reference Manager,ProCite)
  • BibTex
  • Text


  • Citation Only
  • Citation and Abstract

Liquid Based Cytology Cervical Cancer Screening Program—Georgian Experience

1 Georgian Telemedicine Union (Association), Kostava str., 0171, Tbilisi, Georgia;
2 New Vision University, Mikeladze str., 0159, Tbilisi, Georgia

Objective:The study aimed to evaluate liquid based cytology as a tool for cervical cancer screening in Georgia.Materials and Methods:1293 cervical cytology samples have been analyzed in Georgia. The samples had been collected and processed by the usage of materials and equipment provided by Hologic. Prepared smears were post-fixed in 96% ethanol and stained accordingly with Papanicolau protocol. The Bethesda 2001 system terminology was employed for reporting and diagnoses of cervical smears.Results:The negative for intraepithelial lesion or malignancy (NILM) category was equal to 1156 cases (89.40%). Other categories in decreasing order were atypical squamous cells of undetermined significance (ASCUS) with 104 cases (8.04%), low grade squamous intraepithelial lesion (L-SIL) with 8 cases (0.62%), high grade squamous intraepithelial lesion (H-SIL) with 1 case (0.08%), atypical squamous cells, cannot exclude high grade intraepithelial lesion (ASC-H) with 21 cases (1.63%) and atypical glandular cells of undetermined significance (AGUS) with 3 cases (0.23%). Cellularity was lower in liquid based cytology (LBC) as compared with conventional smears (CS). Also, nuclear overlap was significantly less observed compared to CS. The smear background was notably cleaner and cell morphology was better evaluated in LBC. In terms of Trichomonas and Candida detection, LBC was superior compared to CS. Doderlein lactobacilli were seen in significantly lesser amounts and were mainly situated in close vicinity to the squamous epithelial cells. Due to lack of pretreatment, the degree of inflammation was better assessed in CS. Conclusion: Our experience shows that LBC is superior to CS in the evaluation ofcell morphology and detection of certain microorganisms such as Trichomonas and Candida. The degree of inflammation is better assessed with CS.
  Article Metrics


1. Costa MOLP, Heráclio SA, Coelho AVC, et al. (2015) Comparison of conventional Papanicolaou cytology samples with liquid-based cervical cytology samples from women in Pernambuco, Brazil. Braz J Med Biol Res 48: 831–838.

2. WHO | Comprehensive cervical cancer control [Internet]. WHO. [cited 2015 Sep 29]. Available from:

3. WHO | Human papillomavirus (HPV) and cervical cancer [Internet]. WHO. [cited 2015 Sep 29]. Available from:

4. Schiffman M, Solomon D (2003) Findings to date from the ASCUS-LSIL Triage Study (ALTS). Arch Pathol Lab Med 127: 946–949.

5. Bergeron C, Masseroli M, Ghezi A, et al. (2000) Quality control of cervical cytology in high-risk women. PAPNET system compared with manual rescreening. Acta Cytol 44: 151–157.

6. Fahey MT, Irwig L, Macaskill P (1995) Meta-analysis of Pap test accuracy. Am J Epidemiol 141: 680–689.

7. Ronco G, Segnan N, Giorgi-Rossi P, et al. (2006) Human papillomavirus testing and liquid-based cytology: results at recruitment from the new technologies for cervical cancer randomized controlled trial. J Natl Cancer Inst 98: 765–774.

8. Abulafia O, Pezzullo JC, Sherer DM (2003) Performance of ThinPrep liquid-based cervical cytology in comparison with conventionally prepared Papanicolaou smears: a quantitative survey. Gynecol Oncol 90: 137–144.

9. Arbyn M, Herbert A, Schenck U, et al. (2007) European guidelines for quality assurance in cervical cancer screening: recommendations for collecting samples for conventional and liquid-based cytology. Cytopathol Off J Br Soc Clin Cytol 18: 133–139.

10. Hoelund B (2003) Implementation of liquid-based cytology in the screening programme against cervical cancer in the County of Funen, Denmark, and status for the first year. Cytopathol Off J Br Soc Clin Cytol 14: 269–274.

11. Kavatkar AN, Nagwanshi CA, Dabak SM (2008) Study of manual method of liquid based cervical cytology. Indian J Pathol Microbiol 51: 190–194.

12. Hoda RS (2007) Non-gynecologic cytology on liquid-based preparations: A morphologic review of facts and artifacts. Diagn Cytopathol 35: 621–634.

13. Gerhard R, Schmitt FC. (2014). Liquid-based cytology in fine-needle aspiration of breast lesions: a review. Acta Cytol. 58(6):533–542.

14. Takei H, Ruiz B, Hicks J (2006) Cervicovaginal flora. Comparison of conventional pap smears and a liquid-based thin-layer preparation. Am J Clin Pathol 125: 855–859.

15. Stabile SAB, Evangelista DHR, Talamonte VH, et al. (2012) Comparative study of the results from conventional cervico-vaginal oncotic cytology and liquid-based cytology. Einstein S?o Paulo Braz 10: 466–472.

16. Bidus MA, Maxwell GL, Kulasingam S, et al. (2006) Cost-effectiveness analysis of liquid-based cytology and human papillomavirus testing in cervical cancer screening. Obstet Gynecol 107: 997–1005.

17. Nandini NM, Nandish SM, Pallavi P, et al. (2012) Manual liquid based cytology in primary screening for cervical cancer—a cost effective preposition for scarce resource settings. Asian Pac J Cancer Prev APJCP 13: 3645–3451.

18. Katz IT, Wright AA (2006) Preventing cancer in developing world. N Engl J Med 354: 1110.    

19. Debby L, Sankaranarayanan R (2006) Secondary prevention of cervical cancer. Int J Gynecology Obstetrics 94: S65–S70.

20. World Health Organization 2013. Comprehensive Cervical Cancer Control: a guide to essential practice.

21. Ronco G, Cuzick J, Pierotti P, et al. (2007) Accuracy of liquid based versus conventional cytology: Overall results of new technologies for cervical cancer screening: Randomized controlled trial. BMJ 335: 28.    

22. Solomon D, Nayar R (2004) The Bethesda System for Reporting Cervical Cytology. New York: Springer.

Copyright Info: © 2016, Ekaterina Kldiashvili, et al., licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (

Download full text in PDF

Export Citation

Article outline

Show full outline
Copyright © AIMS Press All Rights Reserved